Antimicrobial Susceptibility Pattern and ESBL Production among Uropathogenic Escherichia coli Isolated from UTI Children in Pediatric Unit of a Hospital in Kerman, Iran.
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Date
2014-03
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Abstract
Aims: Emergence of antibiotic resistance and extended spectrum β- lactamase (ESBL)
among uropathogens in the pediatric unit of hospitals created serious health care concern.
This study deals with antimicrobial susceptibility and ESBL analysis of uropathogenic
Escherichia coli isolated from children hospitalized in pediatric unit of a university hospital in
Kerman, Iran.
Methodology: Fifty-five uropathogens positive samples were recovered from one hundred
thirty five samples collected from urine of the children hospitalized with sign of UTI in
pediatric unit of a hospital, in Kerman, Iran from April 2011 to November 2012.
Preliminary antimicrobial susceptibility testing was carried out using agar disk-diffusion
breakpoint assay and minimum inhibitory concentrations (MICs) of different antibiotics were
determined by agar dilution method. ESBL production was detected by a double disk
synergy test and confirmed by a phenotypic confirmatory test.
Results: Of fifty-five positive samples isolated, Escherichia coli (69%) was the leading
uropathogen followed by Klebsiella spp. (18.8%), Proteus (7.27%), Staphylococcus aureus
(3.63%), Citrobacter (1.8%), Enterobacter spp. (1.81%) and Enterococcus (1.8%).
Antimicrobial susceptibility tests revealed that almost all uropathogenic E. coli were sensitive to carbapenems (100%) and amikacin (94.4%), while, 100% of the strains were
resistant to ampicillin (MIC range ±32 μg/mL), 63.8% were resistant to amoxicillin/clavulanic
acid (MIC range ±32μg/mL), 33% were resistant to trimethoprim- sulfamethoxazole (MIC
range ±64.2μg/mL) and 61.1% of the strains were resistant to third generation of
cephalosporins (MIC range ±8.0μg/mL) (P=0.05). The ESBL confirmatory test for
uropathogenic E. coli isolates resistant to third generation of cephalosporins revealed that
only 20% were produced detectable ESBL enzymes.
Conclusion: From above results it can be concluded that E. coli was the most common
nosocomial pathogen associated with UTI among hospitalized children in our hospital and
amikacin, carbapenems were very effective drugs for treatment of UTI in these age group,
while, care must be taken when third generation of cephalosporins and trimethoprimsulfamethoxazole
are administered.
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Keywords
Escherichia coli, UTI, antimicrobial susceptibility, ESBL, pediatric unit
Citation
Shakibaie Mohammad Reza, Adeli Saied, Salehi Mohammad H. Antimicrobial Susceptibility Pattern and ESBL Production among Uropathogenic Escherichia coli Isolated from UTI Children in Pediatric Unit of a Hospital in Kerman, Iran. British Microbiology Research Journal. 2014 Mar; 4(3): 262-271.